USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1905 > Part 20
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England, Scotland, and Wales
38
265
HEALTH DEPARTMENT.
patient resides, and the librarian of the public library are notified, and state board of health.
Scarlet Fever .- One hundred thirty-seven cases of scarlet fever have been reported during the year, four of which resulted fatally. In 1904 there were one hundred nineteen cases, three of which resulted fatally.
Diphtheria .- One hundred and ninety-nine cases of diph- theria have been reported during the year, seventeen of which were fatal. In 1904 there were three hundred and seventy-one cases, fourteen of which proved fatal. Anti-toxin has been pro- vided by the state board of health, and placed by this board in central locations for use by physicians in cases where people are unable to purchase the same. Culture tubes for diphtheria and sputum bottles for suspected tuberculosis have been obtainable at the same stations.
Warning cards are used in dealing with scarlet fever and with diphtheria, and the premises are fumigated by the use of the formaldehyde gas regenerator, immediately after the termi- nation of the case. An inspection is made by the agent of the board of the premises where diphtheria is reported, and all sani- tary defects discovered are required to be remedied as soon as possible.
Tuberculosis .- Fifty-three cases of tuberculosis have been re- ported during the year. There were eighty-four deaths from this disease.
Typhoid Fever .- Fifty-two cases of typhoid fever have been reported during the year, nine of which have proved fatal. In 1904 there were ninety-six cases reported, eleven of which were fatal.
Typhus Fever, Cholera .- No cases of typhus fever or cholera have been reported the past year.
Smallpox .- No cases of smallpox have been reported during the year.
Number of cases of scarlet fever and diphtheria for which houses
were placarded 336
Number of premises disinfected by agent 572
Disinfection.
It will be seen by the foregoing figures that, in addition to the 336 premises infected with scarlet fever or diphtheria, 236 other premises were disinfected. Thirty-four disinfections were made at the request of attending physicians whose patients had been ill with typhoid fever or cancer. One hundred and sixteen schoolrooms were disinfected for scarlet fever or diphtheria, and eighty-six premises for tuberculosis, in compliance with the regu- lations passed by this board.
Many library books have also been disinfected, and quan- tities of infected bedding and other material have been burned.
256
ANNUAL REPORTS.
TABLES.
The prevalence of scarlet fever, diphtheria, and typhoid fever in the city during the several months of the year 1905 is shown by the following table, and in the table next following is given the number of deaths from these three diseases, by months, during the last ten years :-
Scarlet Fever, Diphtheria, and Typhoid Fever Reported in 1905.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
MONTHS.
Cases
Reported.
Number of
Deaths.
Percentage
of Deaths.
Reported.
Number of
Percentage
of Deaths.
Reported.
Number of
Percentage
of Deaths.
January
6
35
3
8.6
....
...
..
February
7
1
14.3
21
2
9.5
6
....
..
March
16
1
6.3
11
...
. .
...
April
10
..
. .
18
1
5.6
2
1
50.0
May .
7
1
16.4
9
1
...
3
1
33 3
August
7
1
14.3
4
1
4.6
10
. .
1
11,1
November .
19
....
....
19
3
15.8
3
3
100.0
December .
32
. ..
....
23
3
13.1
1
1
100.0
Total .
137
4
2.9
199
17
8.6
52
9
17.3
Deaths from Scarlet Fever, Diphtheria, and Typhoid Fever in the Last Ten Years.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
MONTHS.
1896.
1897.
1898.
1899.
1901.
190%.
1903.
1904.
1905.
1896.
1897.
1898.
1899.
1900.
1901.
1902.
1903.
1904.
1905.
1896.
1897.
1898.
1899.
1900.
1901.
1902.
1903.
1904.
1905.
January
1
10
4
2
1
1
3
1
February .
March
-
1
1
5
1
2
1
1
1
2
1
2
1
May
4
7
1
5
3
2
2
3
1
1
1
1
1
1
June
2
1
3
1
1
2
1
1
1
2
July
5
1
·
..
.
1
2
1
2
2
1
2
1
1
. .
September
2
1
1
5
1
6
3
2
2
2
3
2
1
3
1
1
2
1
November
2
1
7
8
2
1
3
2
3
3
5
1
3
2
3
3
December
1
3
1
1
3
1
:
6
1
1
5
4
1
5
2
2
3
1
..
1
3
.
co .
. .
1
1
Total
5 6 0 3 7 5 310
3 4 54 44 10 11 49 29
19 19 14 17
26 11 11 15
9 12, 6 10 11
9
June .
6
2
2
100.0
July .
4
. . .
1
.
....
. .
10
. .
September .
7
. .
21
2
9.5
9
October
16
. .
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1
1
1
1
1
. .
April
1
1
2
3
3
.
..
7
9
1
2
1
6
2
2
1
3
1
2
.
.
.
. .
1
1
2
1
1
1
1
1
.
2
August
2
.
2
1
·
4
1
1.
5
2
3
5
. .
1
..
:
-
-
-
-
1
6.7
5
15
Deaths.
Cases
Deaths.
Cases
....
1
1900.
-
4
1
1
1
October .
.
1
3
1
22
267
HEALTH DEPARTMENT.
Contagious Hospital.
With the growth of a city there is an increasing liability to the prevalence of contagious diseases, and the problem of con- trolling these affections and preventing serious epidemics be- comes a difficult one to solve. It is a well-recognized fact that if persons suffering with these diseases can be properly isolated, the danger of the spread of the contagion is averted. In many cases occurring in private homes and apartment houses, anything like suitable isolation and necessary care are impossible, and unless the patient can be removed, the other members of the family, or the members of several families are more or less exposed to the infection.
The large cities have long maintained hospitals in which persons suffering with these diseases could be treated, and many of the smaller cities have recently established such hospitals. The city of Somerville purchased the Russell estate at the corner of North street and Broadway, West Somerville, on May 17, 1901, for the purpose of establishing a contagious hospital. For some reason nothing further was done until a year ago, when the agitation in favor of the project was renewed, and later on an appropriation of $5,000 was made by the board of aldermen for the purpose of converting the Russell house in its present loca- tion into a contagious hospital, the balance of the land having . been transferred to the overseers of the poor department by the board of aldermen.
Work was begun early in the fall, and has progressed so rapidly that the building is nearly ready for occupancy. The in- terior of the old building has been entirely remodeled, and an addition has been built containing rooms for the matron and nurses, besides a kitchen, laundry, isolation ward, and serving rooms. The first floor of the main building will be used for diph- theria patients, and cases of scarlet fever will be treated on the second floor. The rooms and halls are so arranged that the two diseases will be kept entirely separate.
There are two large wards, in which several beds can be placed, and smaller rooms for one or two patients. Everything has been so planned that the building is well adapted for the pur- pose intended. Forty or more patients can be accommodated at one time, and the facilities for taking care of them will be of the best and most modern character.
Here patients may be taken when proper isolation or care are impossible at home, and thus will the prevalence of these dis- eases be better controlled and the public health be better pro- tected.
Bacteriological Department.
The work of this department was performed by Frank L. Morse, M. D., whose report is appended to this report :-
268
ANNUAL REPORTS.
Specimens will be received at the laboratory at the city hall daily, including Sunday, at any time, and they will be examined and reported upon the morning following their reception.
SPECIMENS AND ANTI-TOXIN.
Outfits for specimens for tuberculosis, diphtheria, typhoid fever and malaria, and diphtheria anti-toxin and vaccine lymph may be obtained at the laboratory and at the following places :-
Charles H. Crane, 154 Perkins street.
Will B. Fitts, 173 Washington street.
Milton H. Plummer, 25 Union square.
Fred W. Gay, 524 Somerville avenue.
Hart Brothers, 263 Highland avenue.
Percy A. Hall, 2 Studio building, Davis square.
Herbert E. Bowman, 529 Medford street, Magoun square.
Eugene B. Carpenter, 10 Broadway.
Julius E. Richardson, 310 Broadway.
After the specimen is collected, it must be taken or sent directly to the laboratory at the city hall.
Districts.
A map showing the health districts was printed with the annual reports for 1904 and previous years. This division of dis- tricts was made by the board of health of 1878, and has since remained unchanged.
A record has been kept from year to year, of the number of deaths, the death rate per thousand, the prevalence of dangerous diseases, and the number of nuisances abated in these several dis- tricts, and is continued in the following tables, and in the table near the beginning of this report.
The estimated population in the several districts was origi- nally based on the number of assessed polls in each, and upon the population of the entire city ; the ratio of polls to population being presumed to be the same in all the districts. Substantially the same method of estimating the population has been con- tinued, the census of every fifth year being taken as a basis for calculation.
The number of dwellings and of assessed polls May 1. 1905, has been obtained from the assessors' books.
1
269
Table of Deaths in Each District During the Last Ten Years.
Districts .
1
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
×
Entire City.
Area
337 A.
107 A.
93 A.
171 A.
361 A.
285 A.
194 A.
482 A.
174 A.
456 A.
2,660 A.
Population
·
6,853
6,985
5,315
5,529
15,416
10,755
5,056
4,670
4,840
4,581
70,000
In 1905.
Dwellings
1,090
1,148
704
881
2,759
1,739
895
896
836
976
11,924
Average in each dwelling .
6.3
6.1
7.5
6.3
5.6
6.2
5.7
5.2
5.8
4.7
5.9
Number of
Deaths.
Rate
per 1,000.
Number of
Deaths.
per 1,000.
Number of
Rate
per 1,000.
Deaths.
Rate
Rate
per 1,000.
Number of
Deaths.
Rate
per 1,000.
Number of
Deaths.
per 1,000.
Number of
Deaths.
Rate
per 1,000.
Number of
Deaths.
Rate
per 1,000.
Number of
Deaths.
per 1,000.
Number of
Deaths.
Rate
per 1,000.
1896 .
155
22
18
77
17
105
19
180
16
97 93
16 15
82 68
46 40
16 14
29
8
53
18
859
15
1898 .
161
23
67
13
79
16
88
17
194
18
92
15
93
14
28
9
50
12
28
00
880
15
1899
102
14
68
13
81
16
113
19
14
14
87
5
34
=
12
54
12
51
15
967
16
1900
.
·
17
74
12
70
13
67
11
178
15
65
10
82 66
41 47
14
58
11
73
20
831
13
1901
.
140
18
80
13
75
14
73
12
184
18
70
10
71
53
15
63
12
81
20
890
13
1902
.
158
20)
79
13
76
14
89
14
151
12
96
14
90
64
17
65
12
87
18
955
14
1904 .
175
21
58
9
85
15
79
10
165
15
131
18
89
11
46
11
52
10
84
15
964
14
1905 .
169
24
61
9
78
15
91
17
158
11
111
10
90
17
51
11
68
14
91
19
968
14
Average death rate per 1,000 for } ten years · .
20
13
15
16
15
14
12
13
11
16
14
co
52
21
924
17
1897 .
158
22
15
80
16
88
17
170
15
155 229
87 82
13
11
134
17
92
15
87
16
115
19
20
.
.
.
46
11
28
9
801 13
1903
·
HEALTH DEPARTMENT.
YEAR.
Rate
Deaths.
Number of
per 1,000.
Number of
Deaths.
Rate
13
12
550
133
94 80
36
Rate
270
ANNUAL REPORTS.
Table Showing the Five Principal Causes of Death in Somerville in 1905, with the Number and Rate in Each District.
PNEUMONIA.
TUBERCULOSIS.
HEART DISEASE.
APOPLEXY.
NEPHRITIS.
DISTRICTS.
Number of
Deaths.
Number per
Number of
Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
10,000 of Pop.
Number of
Deaths.
Number per
10,000 of Pop.
I.
16
23.4
20
29.2
15
21.9
10
14.6
8
11.7
II.
8
11.5
5
7.1
10.1
5
7.1
8.7
III.
14
26.3
15.1
9
16.9
6
11.3
9.4
IV.
15
27.1
co
23.6
9
16.3
4
7.2
9.1
V.
20
12.9
5.2
0
6.5
11
7.1
6.5
VI.
17
15.8
8.4
9
8.4
7
6.5
7
6.5
VII.
21.8
9.9
8
15.8
8
15.8
6
17.8
VIII.
12.9
6
12.9
7
14.9
5
10.8
3
6.5
IX.
22.8
5
10.4
2
6.2
5
10.4
6
12.4
X.
19.6
5
10.9
5
10.9
3
6.6
4
8.7
Total .
127
18.2
84
12.0
82
11.7
64
9.1
63
9.0
Table of Scarlet Fever, Diphtheria, and Typhoid Fever in Each District in 1905.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
DISTRICTS.
Reported.
Reported.
Deaths.
Cases per
Deaths per
Reported.
Deaths.
Cases per
Deaths per
I.
20
1
2.92
0.15
25
3.65
0.15
9
2
0.88
0.29
II.
17
1
2.44
0.14
III.
Cr
0.94
31
5.83
0.19
6
1
1.13
0.19
IV.
19
1
3.45
0.18
33
1
5.97
0.18
2
1
0.36
0.18
V.
15
0,98
17
3
1.11
-0.19
6
1
0.38
0.07
VI.
18
..
.. .
OH
1
2.18
0.19
3
0.59
...
VIII.
. .
2.14
1
4.07
0.22
IX.
. .
1.24
10
1
1.04
0,21
2
0.41
..
X.
1
1.96
0.22
13
2
2.84
0.44
9
3
1.96
0.36
Total .
137
4
1.96
0.06
199
17
2.84
0.24
52
9
0.74
0.13
...
co
2.79
0.29
14
1
1.31
0 09
VII.
18
. .
3.56
..
191
1.29
0.43
4
.
0.58
1,000 of Pop.
Cases
Deaths.
Cases per
1,000 of Pop.
Deaths per
1,000 of Pop.
1,000 of Pop.
1,000 of Pop.
Cases
1,000 of Pop.
Cases
9
. .
....
..
000
1.67
0, 00 00
OCTOTO
6191
10,000 of Pop.
-
271
Rates Per Thousand of Population of Cases of Scarlet Fever, Diphtheria, and Typhoid Fever Reported and of Deaths from the Same, in the Last Seven Years.
1899.
1900.
1901.
1902.
1903.
1904.
1905.
Av'age for Seven Yrs.
DISTRICTS.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
Scarlet Fever.
Diphtheria.
Typhoid Fever.
I.
§ Cases Deaths .
9.40 2.43 0.81 0.27
0.13
1.30
....
1.29 9.46 1.17 0.26 0.78 . . . .
1.92 1.79 0.51 0.13 0.64 0.13
2.12 0.12
4.60 0.37 0.50 0.12
1.3 9.21 2.63 0.48 0.24
2.92 3.65 0.88 3.38,6.16 1.08 0.15 0.15 0.29
( Cases
2.04 2.04 0.85
1.81
7.09 0.99
0.98 4.59 0.98 .... 0.33 0.16
1.32 2.13 0.32
1.60 0.16
3.36 0.48 0.16 0.16 0.
2. 5.60 1.24 0.11 0.31
2.44 1.29 0.58 0.14 0.43 ....
1.77 3.73 0.78 0.61 1.70 0.97
III.
§ Cases Deaths .
1.99 5.09 0.39
3.66 10.22 2.12
2.13 2.61 0.19
2.56 0.18
4.94 0.18 0.36
0.89 7.41 2.29 0.53 0.18
0.94 5.83 1.13 0.19|0.19
0.08|0.62 0.16
IV.
§ Cases Deaths
3.21 3.04 1.01 0.34
0.49
1.15
..
0.16 0.16
3.12 0.16
3.90 0.31 0.78 0.16
3.45 5.97 0.36 0.18 0.18 0.18
2.80 6.24 0.87 0.12 0.42 0.07
V.
§ Cases Deaths .
3.31 1.74 0.97 0.18
0.35
...
. . .
....
0.17 0.09
1 39 0.16
1.97 0.74 0.33 0 16 ....
2.02 1.78 0.08 0.25
0.98 1.11 0.38 .... 0.19 0.07
2.42 5.19 1.15
VI.
§ Cases Deaths .
3.59 2.34 1.72
2.55
8.99 0.89 0.59 0.15
2.83 3.29 1.94 0.29 0.45 ....
1.74 6.41 1.02 0.29 0.87 0.29
2.30 0.29
3.02 0.43
2.11 9.54 0.71 0.14
1.67 2.79 1.31 0.29 0.09
0.04 0.31 0.17
VII.
§ Cases Deaths .
1.54 1.96 2.09
2.73
4.78 0.96 0.27 0.14
1.35 2.69 0.68 0.14 0.14
0.59 3.02 0.13 0.26
.. ..
....
....
....
...
1.98 3.47 0.49
2.14 4.07
2.51 4.42 0.39
VIII.
§ Cases Deaths .
1.22 2.49
4.53
6.99 0.60 0.30 0.30
0.59 0.29
0.29
....
2.81 4.04 2.63
0.78 2.71
2.97
2 23 0.37
1.43 3.39 0.89
2.41 3.35 1.17
IX.
§ Cases Deaths .
..
....
...
0.19
·
....
....
....
0.12 0.15
X.
§ Cases Deaths .
1.88 2.19 1.88
5.45
7.75 0.58
5.57 8.07 2.51 0.56 1.68 0.28
0.25 0.25 1.72 5.41 0.25 ....
0.21
2.87 1.03 0.41 0.21
4.01 5.56 2.04 0.14 0.19
1.96 2.84 1.96 0.22 0.44
3.38|4.99 1.47 0.16 0.69 0.11
City
§ Cases Deaths .
2.62 2.45 1.22 0.05 0.18 0.25
3.73 0.11
0.79 0.15
2.07 5.39 1.24 0.08 0.46 0.19 0.46 0.29 0.09
1.20 3.45 0.43
2.18 10.15
3.11 0.57 0.28 0.15
1.71 5.34 1.39 1.96 2.84 0.74 2.21 4.42 0.95 0.05 0.21 0.16 0.06 0.24 0.13 0.14 0.35 0.16
....
0.59 0.39
0.19
1.35
...
. .
4.75 15.88 2.13
2.28 7.34 0.82 0.33
1.28 2.56 0.81
1.51 4.98 0.61
....
. ...
4.13
5.08 0.95 0.69 0.43
1.37 4.26 0.86 0.09 0.26
0.59 4.11 0.54
1.30
2.47 1.04 0.13 0.52
2.16 3.43 0.51 0.38 0.13
3.56 2.18 0.50 0.19
1.89 2.93 0.85 0.07 0.19 0.21
..
..
2.19 7.97 0.88
2.56 3.84
0.29
2.91 0.26
2.11 0.53
..
....
0,22
0.04 0.20 0.09
3.95 3.26 2.79 0.23 0.47
3.71
6.81 1.09 0 22 0.22
1.73
..
....
.
.
HEALTH DEPARTMENT.
II.
Deaths
....
0.51 0.34
0.16
....
....
..
0.16
....
..
0.14 .... 0.56
0.27
4.69 11.98 1.17
.. . .
....
0.11 0.59 0.11
2.29 5.16 0.96 0.19 1.31 0.39
2.07 5.89 1.04
...
0.73
1.80 2.89 0.89 0.05 0.22 0.26
...
1.24 1.04 0.41 0.21
0.36
3.08
8.39 1.16
.
272
ANNUAL REPORTS.
Undertakers.
Under the provisions of section 44 of chapter 78 of the re- vised laws of 1902, eighteen persons have been duly licensed as undertakers.
Examiners of Plumbers.
The public statutes provide for a board of examiners of plumbers, consisting of a chairman of the board of health, the inspector of buildings, and an expert at plumbing, to be ap- pointed by the board of health. This board appointed Duncan C. Greene, the inspector of plumbing, to fill the place of expert. The number of licenses granted will be found in the report of the inspector of buildings.
Financial Statement. HEALTH DEPARTMENT.
CREDIT.
Appropriation
$39,500 00
Receipts :----
Milk fees
115 10
Permit fees
66 00
Emanuel Zetterman, care of Gustave
Zetterman
8 00
City of Boston, care of Thane family
16 92
City of Boston, care of Lucy Nuro
315 00
Amounts transferred :-
To health department, collection of ashes and offal
$24,000 00
To public buildings construction, health
1,200 00
25,200 00
Total credit
$14,821 02
Salaries
$1,233 28
Wagons, sleds, etc.
39 11
Tools and repairing same
74 40
Harnesses and horse clothing
5 65
Horses and horse doctoring .
8 65
Horseshoeing
24 00
Vaccine virus
6 65
Burying dead animals
133 50
Office expenses
33 85
Books, stationery, printing and postage
252 05
Bacteriological laboratory
2 67
Board of agent's horse .
275 86
Telephones
93 49
Care of contagious diseases
1,431 12
Incidentals
164 76
Total debit
$6,779 04
Balance unexpended
$8,041 98
.
.
$40,021 02
department
DEBIT.
273
HEALTH DEPARTMENT.
Health Department, Collection of Ashes and Offal.
CREDIT.
Appropriation
$24,000 00
Receipts :---
A. M. Prescott, sale of horse 30 00
Hannibal S. Pond, city offal to April 1, 1905
275 00
Sundry persons, city offal April 1 to De- cember 31 .
4,549 86
Transferred from Highways Maintenance
4,000 00
Total credit
.
$32,854 86
DEBIT.
Salary of superintendent .
$1,200 00
Collecting ashes
17,853 21
Collecting offal
14,945 25
building fence, laying water main, etc.,
912 33
Stable expenses
1,458 00
Wagons, sleds, etc. .
519 05
Extending roof at offal shed and manure pit at stable
278 53
Tools and repairing same
93 85
Washstand, etc., at offal shed
111 67
Hose cock, etc., at offal shed .
88 05
Harnesses and horse clothing
431 06
Horses and horse doctoring .
624 50
Board of superintendent's horse
280 20
Horseshoeing
770 47
Hay and grain .
4,276 69
Incidentals
240 79
Total debit
$44,083 65
Amount overdrawn
$11,228 79
Amount overdrawn, health department, col- lection of ashes and offal .
$11,228 79
Amount unexpended, Health Department account
8,041 98
Net amount expended above original appropriation
$3,186 81
ALLEN F. CARPENTER, Chairman, EDMUND S. SPARROW, WESLEY T. LEE, M. D.,
Board of Health.
Preparing shed,
constructing driveway,
·
·
account
REPORT OF BACTERIOLOGIST.
Somerville, January 10, 1906.
To the Board of Health of the City of Somerville :-
Gentlemen,-I herewith present the report of the bacteriol- ogist for the year 1905.
During the latter part of December, 1902, in accordance with your vote, a laboratory was established at the city hall, and regu- lar bacteriological examinations were commenced upon January 1, 1903, which have been continued during the past year.
During the year 1905 792 examinations were made of cul- tures for the diphtheria organism, 162 examinations made of sputum from patients suspected of having tuberculosis, and seventy-eight examinations to detect the Widal reaction in typhoid fever.
With the beginning of 1903, your board established regula- tions, which required, in cases of diphtheria, that no patient should be released from quarantine until two consecutive nega- tive cultures had been obtained from the patient, one by the at- tending physician and one by a physician representing the board, thus making the work more extensive than had been previously required.
On May 1 of the present year, in response to a request from the Somerville Medical Society, representing the physicians of the city, the taking of the first release culture was made optional with the attending physician, and if so requested, the physician representing the board took all of the release cultures. In addi- tion, it was also voted that all patients ill with scarlet fever should be examined by a physician designated by the board, before re- leasing the family from quarantine, and the bacteriologist was instructed to perform both of these duties, and was made an agent of the board of health. Since this time 209 visits have been made for the purpose of taking release cultures in cases of diphtheria, and 126 visits to examine patients convalescent from scarlet fever, it being necessary to inspect forty-five patients ill with the latter disease a second and sometimes third time before releasing them from quarantine, on account of the process of desquamation still being present.
Culture stations were also established at four different parts of the city, which were later increased to nine in number, to more generally accommodate the physicians of the city, at which places, in connection with the laboratory, culture outfits, diphtheria anti- toxin, typhoid fever outfits, vaccine lymph, and sputum bottles could be obtained. To avoid delay in the examination of speci- mens, it was required that all specimens should be sent to the laboratory at the city hall, thus obviating any delay through the culture stations. Cultures left at the city hall as late as midnight
275
HEALTH DEPARTMENT.
are placed in the incubator immediately, making it possible for a result to be obtained early the next morning.
Diphtheria .- Seven hundred and ninety-two cultures have been examined for diphtheria, 346 being in males, and 446 in females. Diphtheria being a disease of children, 204 of these examinations have been made in children under five years of age, 260 in those from five to ten years of age, 139 from ten to twenty, and 170 in adults over twenty years. In nineteen cases the age of the patient was not stated. Two hundred and sixty-three ex- aminations were made for the diagnosis of the case, sixty-one proving positive, and 202 negative. Of the positive results, fif- teen were of cases in which the attending physician's diagnosis of diphtheria was confirmed, ten in which the clinical diagnosis- was not diphtheria, and thirty-six in which no definite diagnosis was made. Of the 202 negative examinations, twenty-three were obtained in which the clinical diagnosis was diphtheria, seventy- six in which the diagnosis was not diphtheria, and 103 in which no diagnosis had been made.
Five hundred and twenty-five cultures were taken for release. of patients from quarantine, 139 of which were positive, and 386 negative. The importance of taking release cultures is demon- strated by these figures, these patients showing the presence of the bacilli in the throat after the clinical evidence of the disease. had disappeared. In four examinations there was no growth: upon the serum tube.
Tuberculosis .- One hundred and sixty-two examinations: have been made of sputum suspected of containing the tubercle bacillus, twenty-two of which were positive and 140 negative. In forty-nine cases a definite diagnosis of this disease had been made by the attending physician, but in thirty-eight of them the organism could not be detected. In the remainder of the cases, sixty-four were stated as not showing evidence of the disease, five being positive, and in forty-nine cases no statements were made giving information as to its character, six of which were positive. Sixty-nine were males and ninety-three females. Although printed directions accompany each outfit, telling how the speci- men should be obtained, it has not been unusual for specimens to: be sent to the laboratory containing only saliva from the mouth, with no excretion from the lungs or bronchial tubes. Physicians- should be urged to give definite instructions to each patient, relating to the collection of the sputum, for in some instances a negative report would mislead both physician and patient. Con- sumption to-day is recognized as an infectious disease, and all' persons afflicted with it should be instructed in the modern methods for preventing its spread. In some cases this is not done by the attending physician, and during the past two years your board has required that this disease be reported to you, as other infectious diseases are, and that printed instructions and. advice be sent to each patient ill with the disease. The decrease.
.
276
ANNUAL REPORTS.
in the death rate of consumption, and the cure of persons afflicted with it, is due to the improved and intelligent manner with which cases are treated, and the prevention of further spread of the dis- ease is a subject which is of importance to all local boards of health.
Typhoid Fever .- Seventy-eight examinations of the blood of patients suspected of having typhoid fever have been made, twenty-six of which proved positive. In twelve cases a positive diagnosis of this disease had been made by the attending physi- cian, in six cases it was stated not to be typhoid fever, and in the remainder no statement was made relating to the diagnosis. Of the negative results, one was diagnosed as typhoid, five were said not to be typhoid, and in forty-four no diagnosis was made. Forty-five were males and thirty-three females. In two cases the specimens were not satisfactory for examination.
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